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This is VAERS ID 1338191

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1338191
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-16
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER0641 / 2 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, Vaccination failure, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19; Fibrosis pulmonary
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210401; Test Name: SARS-CoV-2 test; Test Result: Positive ; Comments: tested positive for the specific countries variant
CDC 'Split Type': FRPFIZER INC2021553671

Write-up: dyspnoea; fever; Vaccination failure/tested positive for the specific countries variant; COVID-19/tested positive for the specific countries variant; This is a spontaneous report from a contactable other health professional downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-2021050910. A 95-year-old female patient received BNT162B2 (COMIRNATY), 1st dose intramuscularly, administered in arm left on 26Jan2021 (Lot Number: EM0477) as a single dose, 2nd dose intramuscularly, administered in arm left on 16Feb2021 (Lot Number: ER0641) as a single dose for COVID-19 immunisation. Medical history included ongoing COVID-19 (as reported), ongoing fibrosis pulmonary. The patient''s concomitant medications were not reported. The patient experienced vaccination failure/tested positive for the specific countries variant, COVID-19/tested positive for the specific countries variant, both on 01Apr2021 and the events were reported as death, dyspnoea and fever, both on 11Apr2021, and the events were reported as being hospitalization and death. The patient was tested positive for the specific countries variant on 01Apr2021, hospitalized on 11Apr2021 for fever and dyspnoea, death on 14Apr2021. The patient underwent lab tests and procedures which included SARS-CoV-2 test: positive (tested positive for the specific countries variant) on 01Apr2021. The patient died on 14Apr2021. An autopsy was not performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Vaccination failure/tested positive for the specific countries variant; dyspnoea; fever; COVID-19/tested positive for the specific countries variant

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